Improve access to information
Improve access to information
Lack of information is a common cause of errors. Many patients receive medications to which they have known allergies simply because the doctor or nurse didn’t have adequate information at the time the medication was ordered or given.
Doctors, nurses, pharmacists, and other personnel need to have information on medications, patients, and the results of treatment when it is needed, where it is needed, in a form that can be readily used. Computerization of patient, drug, and laboratory information holds great promise in this area, but simpler methods can also work. Likewise, organizations must make information concerning errors and system operations accessible in order to change practice and prevent errors.
Changes that improve access to information:
• Have a pharmacist available on the nursing units and at rounds.
• Use computerized order entry systems.
• Use computerized patient information.
• Use computerized laboratory data to immediately alert clinicians about abnormal lab values.
• Place lab reports and medication records at the bedside.
• Place protocols and ordering information on the patient’s chart and in the medication room where they are easily accessible.
• Color-code wristbands for patients with allergies.
• Provide each patient with a list of his or her medications, doses, and times.
• Track errors or near misses and report those to staff on a weekly basis.
• Accelerate lab turnaround times for blood coagulation tests (partial thromboplastin time or PTTs) and blood sugar tests.
Examples:
• One organization moved the medications and the medication administration record to the bedside to make it easier to see what was needed for the patient.
• One organization began placing a red identification wristband on patients with drug allergies.
• In another organization, each patient received a list of his or her medications daily.
• When the nurse came to administer medications, the nurse reviewed the list with the patient.
Source: Institute for Healthcare Improvement, Boston.
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